JMIR Publications

ABSTRACT

Background:

Telerehabilitation has become increasingly important worldwide as the COVID-19 pandemic forced many rehabilitation centers to change their daily care routine and find new ways to provide medical rehabilitation and aftercare.

Objective:

We investigate the acceptance and implementation conditions of telerehabilitation in Germany, particularly following the COVID-19 pandemic.

Methods:

We conducted qualitative semi-structured interviews with patients (n = 9) and healthcare professionals (n = 8) between September 2023 and January 2024. To explore individual and structural barriers and facilitators of telerehabilitation adoption we employed the Unified Theory of Acceptance and Use of Technology (UTAUT 2) and the Consolidated Framework for Implementation Research (CFIR).

Results:

Patients and healthcare professionals perceive telerehabilitation as positive, mainly due to its flexibility and accessibility. Patients expressed high acceptance levels, anticipating health benefits, although they found it challenging to familiarize themselves with the technology and establish routines. Healthcare professionals highlighted the need for adequate resources (financial, time, and personnel) and management support to implement telerehabilitation successfully. Both groups saw higher acceptance and cost coverage of telerehabilitation services as essential for successful implementation and use in Germany.

Conclusions:

Our study identified institutional barriers such as concerns about resource availability, team communication, and initial resistance among healthcare staff to the introduction of new technologies. At an individual level, we found that patients struggle with routine establishment, and that digital and in-person institutional and peer support could mitigate this challenge. Implementing a hybrid approach, improved funding and approval processes would enhance telerehabilitation integration in the German healthcare sector.